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General NPI Number Information
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NPI Number | 1245411024
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Entity Type | Individual
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Provider Name | TONY LAMAR OWENS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 9404 HIGHWAY 78 SUITE 100
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City | LADSON
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State | SC
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Zip | 29456-3909
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Country | US
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Telephone | 843-737-0437
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Fax | 843-789-3053
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Provider Business Mailing Address
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Address Line | 9404 HIGHWAY 78 SUITE 100
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City | LADSON
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State | SC
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Zip | 29456-3909
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Country | US
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Telephone | 843-737-0437
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Fax | 843-789-3053
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 201000443
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 33911
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License Number State | SC
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